| NPI | 1588457147 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC LL94416) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: SC LL94416) |
| Enumeration Date | 2025-05-27 |
| Last Update Date | 2025-05-27 |